The Journal of Practical Medicine >

2024 , Vol. 40 >Issue 11: 1568 - 1573

DOI: https://doi.org/10.3969/j.issn.1006-5725.2024.11.017

Drugs and Clinic Practice

Thrombolysis with low⁃dose and standard⁃dose intravenous recombinant tissue plasminogen activator in elderly patients with acute ischemic stroke： a stratified analysis

  • Yawei GU ,
  • Xu CHU ,
  • Lujing ZHAO ,
  • Bo HONG ,
  • Zhikuan LUO ,
  • Zhanzeng LIN ,
  • Jingzhen GAO ,
  • Yinhua DONG ,
  • Lijun WANG ,
  • Nian. CHEN
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  • *.Department of Neurology，Tianjin Fourth Central Hospital，Tianjin 300140，China

Received date: 2023-08-30

  Online published: 2024-06-13

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Abstract

Objective To investigate the efficacy and safety of intravenous thrombolysis with low?dose and standard?dose recombinant tissue plasminogen activator （rt?PA） in the elderly patients （aged over 80 years） with acute ischemic stroke （AIS）. Methods A total of 201 elderly patients with AIS treated at Tianjin Fourth Central Hospital from February 2019 to February 2023 were prospectively included and randomly assigned to the rt?PA low?dose group （n = 93， 0.6 mg/kg） and rt?PA standard?dose group （n = 108， 0.9 mg/kg）. The incidence of intracranial hemorrhage， symptomatic intracranial hemorrhage， fatal intracranial hemorrhage， neurologic deterioration within 7 days and mortality within 90 days were observed to evaluate the safety. The neurologic improvement rate and good prognosis rate at 90 days were used to evaluate the effectiveness. A stratified analysis of 90?day outcomes was performed based on stroke severity and age. Results The incidence of intracranial hemorrhage， symptomatic intracranial hemorrhage and fatal intracranial hemorrhage within 7 days in rt?PA low?dose group was lower than that in rt?PA standard?dose group （P < 0.05）. There were no statistically significant differences between the two groups concerning the residual safety index and the effectiveness index. The 90?day good prognosis rate of moderate stroke sub?group and of ≥ 90 years of age sub?group in rt?PA low?dose group were both higher than that of rt?PA standard?dose group （P < 0.05）. Conclusions For AIS patients with moderate stroke and aged over 90 years， intravenous thrombolytic therapy with rt?PA 0.6 mg/kg is recommended.

Key words： acute ischemic stroke; advanced age; tissue plasminogen activator; thrombolysis

Cite this article

Yawei GU , Xu CHU , Lujing ZHAO , Bo HONG , Zhikuan LUO , Zhanzeng LIN , Jingzhen GAO , Yinhua DONG , Lijun WANG , Nian. CHEN . Thrombolysis with low⁃dose and standard⁃dose intravenous recombinant tissue plasminogen activator in elderly patients with acute ischemic stroke： a stratified analysis[J]. The Journal of Practical Medicine, 2024 , 40(11) : 1568 -1573 . DOI: 10.3969/j.issn.1006-5725.2024.11.017

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